Individual
DR. MASOUD REZVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3131 PRINCETON PIKE, BLD 5 SUITE 109, LAWRENCEVILLE, NJ 08648-2201
(609) 912-1145
(609) 912-1147
Mailing address
3131 PRINCETON PIKE, BLD 5 SUITE 109, LAWRENCEVILLE, NJ 08648-2201
(609) 912-1145
(609) 912-1147
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
155620
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3031802
—
NJ
Enumeration date
07/08/2006
Last updated
07/08/2007
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